Comparison of the drug-drug interactions potential of erlotinib and gefitinib via inhibition of UDP-glucuronosyltransferases

Drug Metab Dispos. 2010 Jan;38(1):32-9. doi: 10.1124/dmd.109.029660.

Abstract

We aimed to investigate and compare the effects of erlotinib and gefitinib on UDP-glucuronosyltransferase (UGT) activities and to quantitatively evaluate their drug-drug interaction (DDI) potential due to UGT inhibition. The inhibitory effects of erlotinib and gefitinib on UGTs were determined using high-performance liquid chromatography by measuring the formation rates for 4-methylumbelliferone (4-MU) glucuronide, imipramine N-glucuronide, and bilirubin glucuronides using recombinant human UGT isoforms and human liver microsomes (HLMs) in the absence or presence of erlotinib and gefitinib. Inhibition kinetic studies were conducted. Area under the curve (AUC) ratios were used to predict the risk of potential DDI in vivo. Erlotinib exhibited selective potent competitive inhibition against 4-MU glucuronidation by UGT1A1, and gefitinib demonstrated a wide range of inhibition against UGT-mediated 4-MU glucuronidation, particularly against UGT1A1, UGT1A7, UGT1A9, and UGT2B7. Erlotinib also exerted potent mixed inhibition against bilirubin glucuronidation in HLMs. We estimated that coadministration of erlotinib at 100 mg/day or higher doses may result in at least a 30% increase in the AUC of drugs predominantly cleared by UGT1A1. Thus, the coadministration of erlotinib with drugs primarily cleared by UGT1A1 may result in potential DDI. In contrast, gefitinib is unlikely to cause a clinically significant DDI through inhibition of glucuronidation.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Area Under Curve
  • Bilirubin / metabolism
  • Binding, Competitive / physiology
  • Biocatalysis / drug effects
  • Cell Line
  • Child
  • Drug Interactions / physiology
  • Erlotinib Hydrochloride
  • Female
  • Gefitinib
  • Glucuronic Acid / metabolism
  • Glucuronosyltransferase / antagonists & inhibitors*
  • Glucuronosyltransferase / genetics
  • Glucuronosyltransferase / metabolism
  • Humans
  • Hymecromone / analogs & derivatives
  • Hymecromone / metabolism
  • Imipramine / metabolism
  • Indinavir / pharmacology
  • Isoenzymes / antagonists & inhibitors
  • Isoenzymes / genetics
  • Isoenzymes / metabolism
  • Kinetics
  • Male
  • Microsomes, Liver / drug effects
  • Microsomes, Liver / enzymology
  • Middle Aged
  • Models, Biological
  • Protein Kinase Inhibitors / metabolism
  • Protein Kinase Inhibitors / pharmacokinetics
  • Protein Kinase Inhibitors / pharmacology
  • Quinazolines / pharmacokinetics
  • Quinazolines / pharmacology*
  • Recombinant Proteins / antagonists & inhibitors
  • Recombinant Proteins / genetics
  • Recombinant Proteins / metabolism
  • Young Adult

Substances

  • Isoenzymes
  • Protein Kinase Inhibitors
  • Quinazolines
  • Recombinant Proteins
  • Hymecromone
  • Indinavir
  • Glucuronic Acid
  • Erlotinib Hydrochloride
  • Glucuronosyltransferase
  • Imipramine
  • Bilirubin
  • Gefitinib